Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

BackgroundDifferent indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality.MethodsWe assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009.ResultsAfter adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78–1.34), 1.30 (0.97–1.75) and 1.55 (1.06–2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88–1.59), 1.02 (0.74–1.41) and 1.57 (1.19–2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial.ConclusionsOur study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality.Trial RegistrationControlled-Trials.com ISRCTN3573963

Increased Expression of AQP 1 and AQP 5 in Rat Lungs Ventilated with Low Tidal Volume is Time Dependent

Background and GoalsMechanical ventilation (MV) can induce or worsen pulmonary oedema. Aquaporins (AQPs) facilitate the selective and rapid bi-directional movement of water. Their role in the development and resolution of pulmonary oedema is controversial. Our objectives are to determine if prolonged MV causes lung oedema and changes in the expression of AQP 1 and AQP 5 in rats.Methods25 male Wistar rats were subjected to MV with a tidal volume of 10 ml/kg, during 2 hours (n = 12) and 4 hours (n = 13). Degree of oedema was compared with a group of non-ventilated rats (n = 5). The expression of AQP 1 and AQP 5 were determined by western immunoblotting, measuring the amount of mRNA (previously amplified by RT-PCR) and immunohistochemical staining of AQPs 1 and 5 in lung samples from all groups.ResultsLung oedema and alveolar-capillary membrane permeability did not change during MV. AQP-5 steady state levels in the western blot were increased (p<0.01) at 2 h and 4 h of MV. But in AQP-1 expression these differences were not found. However, the amount of mRNA for AQP-1 was increased at 2 h and 4 h of MV; and for AQP 5 at 4 h of MV. These findings were corroborated by representative immunohistochemical lung samples.ConclusionIn lungs from rats ventilated with a low tidal volume the expression of AQP 5 increases gradually with MV duration, but does not cause pulmonary oedema or changes in lung permeability. AQPs may have a protective effect against the oedema induced by MV

Dietary levels of pure flavonoids improve spatial memory performance and increase hippocampal brain-derived neurotrophic factor.

Evidence suggests that flavonoid-rich foods are capable of inducing improvements in memory and cognition in animals and humans. However, there is a lack of clarity concerning whether flavonoids are the causal agents in inducing such behavioral responses. Here we show that supplementation with pure anthocyanins or pure flavanols for 6 weeks, at levels similar to that found in blueberry (2% w/w), results in an enhancement of spatial memory in 18 month old rats. Pure flavanols and pure anthocyanins were observed to induce significant improvements in spatial working memory (p = 0.002 and p = 0.006 respectively), to a similar extent to that following blueberry supplementation (p = 0.002). These behavioral changes were paralleled by increases in hippocampal brain-derived neurotrophic factor (R = 0.46, p<0.01), suggesting a common mechanism for the enhancement of memory. However, unlike protein levels of BDNF, the regional enhancement of BDNF mRNA expression in the hippocampus appeared to be predominantly enhanced by anthocyanins. Our data support the claim that flavonoids are likely causal agents in mediating the cognitive effects of flavonoid-rich foods

Randomised controlled trial combining vitamin E-functionalised chocolate with physical exercise to reduce the risk of protein-energy malnutrition in predementia aged people: study protocol for Choko-Age

Objective: Protein-energy malnutrition and the subsequent muscle wasting (sarcopenia) are common ageing complications. It is knowing to be also associated with dementia. Our programme will test the cytoprotective functions of vitamin E combined with the cortisol-lowering effect of chocolate polyphenols (PP), in combination with muscle anabolic effect of adequate dietary protein intake and physical exercise to prevent the age-dependent decline of muscle mass and its key underpinning mechanisms including mitochondrial function, and nutrient metabolism in muscle in the elderly. Methods and analysis: In 2020, a 6-month double-blind randomised controlled trial in 75 predementia older people was launched to prevent muscle mass loss, in respond to the 'Joint Programming Initiative A healthy diet for a healthy life'. In the run-in phase, participants will be stabilised on a protein-rich diet (0.9-1.0 g protein/kg ideal body weight/day) and physical exercise programme (high-intensity interval training specifically developed for these subjects). Subsequently, they will be randomised into three groups (1:1:1). The study arms will have a similar isocaloric diet and follow a similar physical exercise programme. Control group (n=25) will maintain the baseline diet; intervention groups will consume either 30 g/day of dark chocolate containing 500 mg total PP (corresponding to 60 mg epicatechin) and 100 mg vitamin E (as RRR-alpha-tocopherol) (n=25); or the high polyphenol chocolate without additional vitamin E (n=25). Muscle mass will be the primary endpoint. Other outcomes are neurocognitive status and previously identified biomolecular indices of frailty in predementia patients. Muscle biopsies will be collected to assess myocyte contraction and mitochondrial metabolism. Blood and plasma samples will be analysed for laboratory endpoints including nutrition metabolism and omics. Ethics and dissemination: All the ethical and regulatory approvals have been obtained by the ethical committees of the Azienda Ospedaliera Universitaria Integrata of Verona with respect to scientific content and compliance with applicable research and human subjects' regulation. Given the broader interest of the society toward undernutrition in the elderly, we identify four main target audiences for our research activity: national and local health systems, both internal and external to the project; targeted population (the elderly); general public; and academia. These activities include scientific workshops, public health awareness campaigns, project dedicated website and publication is scientific peer-review journals. Trial registration number: NCT05343611

The Power of Exercise: Buffering the Effect of Chronic Stress on Telomere Length

BACKGROUND: Chronic psychological stress is associated with detrimental effects on physical health, and may operate in part through accelerated cell aging, as indexed by shorter telomeres at the ends of chromosomes. However, not all people under stress have distinctly short telomeres, and we examined whether exercise can serve a stress-buffering function. We predicted that chronic stress would be related to short telomere length (TL) in sedentary individuals, whereas in those who exercise, stress would not have measurable effects on telomere shortening. METHODOLOGY AND PRINCIPAL FINDINGS: 63 healthy post-menopausal women underwent a fasting morning blood draw for whole blood TL analysis by a quantitative polymerase chain reaction method. Participants completed the Perceived Stress Scale (Cohen et al., 1983), and for three successive days reported daily minutes of vigorous activity. Participants were categorized into two groups-sedentary and active (those getting Centers for Disease Control-recommended daily amount of activity). The likelihood of having short versus long telomeres was calculated as a function of stress and exercise group, covarying age, BMI and education. Logistic regression analyses revealed a significant moderating effect of exercise. As predicted, among non-exercisers a one unit increase in the Perceived Stress Scale was related to a 15-fold increase in the odds of having short telomeres (p&lt;.05), whereas in exercisers, perceived stress appears to be unrelated to TL (B = -.59, SE = .78, p = .45). DISCUSSION: Vigorous physical activity appears to protect those experiencing high stress by buffering its relationship with TL. We propose pathways through which physical activity acts to buffer stress effects

European contribution to the study of ROS : A summary of the findings and prospects for the future from the COST action BM1203 (EU-ROS)

AbstractThe European Cooperation in Science and Technology (COST) provides an ideal framework to establish multi-disciplinary research networks. COST Action BM1203 (EU-ROS) represents a consortium of researchers from different disciplines who are dedicated to providing new insights and tools for better understanding redox biology and medicine and, in the long run, to finding new therapeutic strategies to target dysregulated redox processes in various diseases. This report highlights the major achievements of EU-ROS as well as research updates and new perspectives arising from its members. The EU-ROS consortium comprised more than 140 active members who worked together for four years on the topics briefly described below. The formation of reactive oxygen and nitrogen species (RONS) is an established hallmark of our aerobic environment and metabolism but RONS also act as messengers via redox regulation of essential cellular processes. The fact that many diseases have been found to be associated with oxidative stress established the theory of oxidative stress as a trigger of diseases that can be corrected by antioxidant therapy. However, while experimental studies support this thesis, clinical studies still generate controversial results, due to complex pathophysiology of oxidative stress in humans. For future improvement of antioxidant therapy and better understanding of redox-associated disease progression detailed knowledge on the sources and targets of RONS formation and discrimination of their detrimental or beneficial roles is required. In order to advance this important area of biology and medicine, highly synergistic approaches combining a variety of diverse and contrasting disciplines are needed.Abstract The European Cooperation in Science and Technology (COST) provides an ideal framework to establish multi-disciplinary research networks. COST Action BM1203 (EU-ROS) represents a consortium of researchers from different disciplines who are dedicated to providing new insights and tools for better understanding redox biology and medicine and, in the long run, to finding new therapeutic strategies to target dysregulated redox processes in various diseases. This report highlights the major achievements of EU-ROS as well as research updates and new perspectives arising from its members. The EU-ROS consortium comprised more than 140 active members who worked together for four years on the topics briefly described below. The formation of reactive oxygen and nitrogen species (RONS) is an established hallmark of our aerobic environment and metabolism but RONS also act as messengers via redox regulation of essential cellular processes. The fact that many diseases have been found to be associated with oxidative stress established the theory of oxidative stress as a trigger of diseases that can be corrected by antioxidant therapy. However, while experimental studies support this thesis, clinical studies still generate controversial results, due to complex pathophysiology of oxidative stress in humans. For future improvement of antioxidant therapy and better understanding of redox-associated disease progression detailed knowledge on the sources and targets of RONS formation and discrimination of their detrimental or beneficial roles is required. In order to advance this important area of biology and medicine, highly synergistic approaches combining a variety of diverse and contrasting disciplines are needed

Functional Transcriptomic Analysis of Centenarians’ Offspring Reveals a Specific Genetic Footprint That May Explain That They Are Less Frail Than Age-Matched Noncentenarians’ Offspring

Abstract Centenarians exhibit extreme longevity and compression of morbidity and display a unique genetic signature. Centenarians’ offspring seem to inherit centenarians’ compression of morbidity, as measured by lower rates of age-related pathologies. We aimed to ascertain whether centenarians’ offspring are less frail and whether they are endowed with a “centenarian genetic footprint” in a case–control study, matched 1:1 for gender, age ±5 years, and place of birth and residence. Cases must have a living parent aged 97 years or older, aged 65–80 years, community dwelling, not suffering from a terminal illness, or less than 6 months of life expectancy. Controls had to meet the same criteria as cases except for the age of death of their parents (not older than 89 years). Centenarians were individuals 97 years or older. Frailty phenotype was determined by Fried’s criteria. We collected plasma and peripheral blood mononuclear cells from 63 centenarians, 88 centenarians’ offspring, and 88 noncentenarians’ offspring. miRNA expression and mRNA profiles were performed by the GeneChip miRNA 4.0 Array and GeneChip Clariom S Human Array, respectively. We found a lower incidence of frailty among centenarians’ offspring when compared with their contemporaries’ noncentenarians’ offspring (p &amp;lt; .01). Both miRNA and mRNA expression patterns in centenarians’ offspring were more like those of centenarians than those of noncentenarians’ offspring (p &amp;lt; .01). In conclusion, centenarians’ offspring are less frail than age-matched noncentenarians’ offspring, and this may be explained by their unique genetic endowment.</jats:p

Diagnostic value of the handgrip strength in detecting protein-energy wasting among patients on maintenance hemodialysis at National Kidney and Transplant Institute, Philippines

Summary: Background and aims: Protein energy wasting (PEW) is a syndrome of adverse nutritional changes common to chronic kidney disease patients. Handgrip strength (HGS) is a method to screen PEW as mentioned in the Kidney Disease Outcomes Quality Initiative Guidelines. However, determining the validity of such method requires further and more thorough studies. This study, therefore, aims to determine the diagnostic validity of HGS in detecting PEW among patients on MHD. Methods: A cross-sectional study of 143 randomly-selected patients on MHD in a Philippine tertiary government specialty hospital from September to October, 2022 was conducted. Diagnosis of PEW was based on the Malnutrition Inflammation Score ≥5. HGS was measured using a dynamometer pre- and post-hemodialysis sessions. Results: The prevalence of PEW among the included patients was 53.15% (95% CI: 44.89–61.24%). The majority were <60 years old and were males, with a median dialysis vintage of 24 months. The most common comorbidity was hypertension, and hypertensive nephrosclerosis was the most common kidney disease etiology. HGS measured pre-hemodialysis (AUC: 0.77) and post-hemodialysis (AUC: 0.76) showed acceptable discriminative ability detecting PEW regardless of patient sex. Among males, both pre-hemodialysis (cutoff: <16.3, sensitivity: 64%, specificity: 86%) and post-hemodialysis (cutoff: <17.9, sensitivity: 71%, specificity: 74%) HGS measures showed acceptable diagnostic value parameters. However, in females, only the pre-hemodialysis HGS measure was acceptable (cutoff: <18.6, sensitivity: 83%, specificity: 65%). Although post-hemodialysis specificity was 88%, sensitivity was only 50%. Conclusion: The diagnostic performance of HGS in detecting PEW was found to be acceptable. While both pre- and post-hemodialysis measures can be used in males, only the pre-hemodialysis measures are recommended for females. HGS can be used as an objective, accurate and inexpensive screening assessment tool in detecting PEW for patients on MHD

Early-warning system:Climate-smart spatial management of UK fisheries, aquaculture and conservation

Our coast and our ocean are undergoing unprecedented changes as a result of the breakdown of our global climate system. These changes represent a significant challenge to the delivery of marine policy that effectively protects ecosystem health, biodiversity and the communities depending on these resources.2 Creating new, climateadaptive management strategies for these ecosystems, and for economic sectors reliant on them, is thus an ongoing challenge facing diverse arine policy frameworks across the UK Nations. This is compounded by an ever-increasing reliance on marine space to meet our need to transition to greener energy supply and economic growth, which have to be carefully balanced against the pressing need to preserve our marine species and habitats, and their ability to adapt to climate change. Marine planning is a public process to document, consult and set priorities about how we manage and share our marine space.Indeed, across our Nations, marine plans thus far enshrine key policies that set out the ambition to deliver climate change adaptation. As a devolved process, operating at national and regional level, marine planning has the potential to serve a key, harmonizing role. It can bring together our broader marine policy mechanisms to help tackle the impacts of global climate change across our waters. Additionally, because planning is a deeply consultative process, it furtheroffers the potential to ensure the voices of those that are affected by marine plans help shape this journey. In order to harness opportunities for effective marine conservation and economic growth that emerge from spatial variationin the sensitivity of our marine ecosystems to climate change, climate-smart marine plans are necessary. However, key capability gaps have this far hindered the ability of UK Nations to deliver such marine plans; i.e. plans that are truly adaptive to the effects of climate change. In this report, we begin to close these gaps. First, we explore areas where policy mechanisms could be strengthened to deliver on this ambition. Second, we capitalize on world-class UK ocean climate modelling capability, to deliver a climate change assessment for the entire UK EEZ that, for the first time, demonstrates the spatial variation in sensitivity of our marine ecosystems to climate change. Third, we make recommendations about how marine planning could support the management of areas identified as climate change refugia for three key sectors – marine conservation, fisheries and aquaculture. We highlight that these areas could be utilized by future climate-smart policy design, to promote the climate change adaptation of our natural marine ecosystems. Our identification of these areas also offers opportunities for sectoral policy design by highlighting where risk from climate change may be lower for our fishing and aquaculture sectors